NPIMap

Organization Active NPI

Baptist ENT Specialists Inc

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1891094264
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BAPTIST ENT SPECIALISTS INC
Practice address
4130 Salisbury Rd
Suite 1900
Jacksonville, FL 32216-8031
Phone
(904) 281-0234
Fax
(904) 281-0236
NPI assigned
Mar 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leeann Mengel
Title
Director
Phone
(904) 376-4275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4130 Salisbury Rd
Suite 1900
Jacksonville, FL 32216-8031

Mailing address

4130 Salisbury Rd
Suite 1900
Jacksonville, FL 32216-8031
Phone (904) 281-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110801000448 FL Part B Supplier - Clinic/Group Practice 4587833983 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4130 Salisbury Rd
Ste 1900
Jacksonville, FL 32216
Phone (904) 281-0234

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1891094264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 SALISBURY RD",
            "address_2": "SUITE 1900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168031",
            "telephone_number": "904-281-0234",
            "fax_number": "904-281-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 SALISBURY RD",
            "address_2": "SUITE 1900",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168031",
            "telephone_number": "904-281-0234",
            "fax_number": "904-281-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST ENT SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "MENGEL",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-376-4275"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.